Introduction Group A Streptococcus (GAS) causes severe infections in children. Winter 2022-2023 saw an unusually high number of admissions for Paediatric pleural empyema in the UK and an association with GAS infection was noted. An analysis of outcomes including length of hospital stay in patients with empyema with or without GAS would help clinicians counsel families and support planning care.

Methods We collaborated with clinicians and implemented a proof-of-concept analysis using the clinical informatics platform PICTURE developed at Great Ormond Street Hospital. The analysis was based on Electronic Health Record (EHR) data from 01/05/2019 to 31/03/2023, extracted using Digital Research Environment processes.

We used PICTURE’s flexible cohort builder to define the two patient cohorts, empyema with GAS and empyema without GAS, by searching the ICD-10 diagnosis data for ‘empyema’ and ‘pyothorax’ and the microbiology test data for GAS positive results. We used PICTURE’s analytics components including Kruskal-Wallis tests to compare the distributions of four outcomes: days on intravenous antibiotics, days with a documented fever (temperature greater than or equal to 38 degrees Celsius), length of stay (days) in the Paediatric Intensive Care Unit (PICU), and length of stay (days) in hospital, with alpha 0.05.

Results We identified seven patients with empyema with GAS positive result and 124 patients with empyema without GAS. Median number of days on intravenous antibiotics was 16 vs 11, number of days with fever 11 vs 4, number of days in PICU 4.6 vs 6.3, number of days at hospital 19 vs 12.5. None of the comparisons were statistically significant.

Conclusions This proof-of-concept study demonstrates that we can use PICTURE’s flexible cohort builder and analytics components to efficiently generate insights to support clinical care, as well as to inform patients and families.

Acknowledgements for funding or support This work is supported by the NIHR GOSH BRC. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. This work is supported by the Great Ormond Street Hospital Children’s Charity.